Heparan Sulfate and Fibronectin Improve the Capacity of Collagen Barriers to Prevent Apical Migration of the Junctional Epithelium

Abstract

The objective of the present study was to assess the effect of bilayered/collagen barriers enriched with fibronectin and heparan sulfate on the prevention of apical migration of the epithelium during the initial stage of periodontal wound healing. Experimental osseous defects were produced on the labial aspect of maxillary canines in dogs. Experimental sites were treated with either bilayered enriched collagen barriers or with non-enriched bilayered collagen barriers, using the guided tissue regeneration technique. Control sites were treated with monolayered collagen barriers that were not enriched with fibronectin and heparan sulfate. Histologic and histomorphometric examinations performed on specimens obtained 20 days post-operative indicate the formation of a short junctional epithelium in the experimental sites treated with enriched collagen barriers. In this group, 95% of the occlusal-apical length of the defects was repopulated by connective tissue cells. In the other 2 groups, a long junctional epithelium developed with only 65% of the occlusal-apical length of the defects being repopulated by connective tissue cells. These findings suggest that the enrichment of collagen barriers with fibronectin and heparan sulfate may be important to enhance the repopulation of exposed root surfaces by connective tissue cells and prevent the apical migration of the epithelium during the initial stages of periodontal wound healing.

Collagen Membranes: A Review

“…33 In addition to cross-linking, heparan sulfate and fibronectin have also been added in an attempt to enhance the inhibitory effect on epithelial migration. In a dog model, Pitaru et al 37 compared the length of the root surfaces repopulated by connective tissue between sites treated with collagen membrane alone, and those treated with a fibronectin and heparan sulfate-enriched collagen membrane. Approximately 30% more root surfaces were repopulated with connective tissue in the fibronectin and heparan sulfate-treated group compared to the collagen alone group.…”

Healing of dehiscence‐type defects in implants placed together with different barrier membranes: a comparative clinical study

“…Collagen membranes have extensively been investigated in animal models (Pitaru et al 1987(Pitaru et al , 1988(Pitaru et al , 1989(Pitaru et al , 1991Pfeifer et al 1989;Hyder et al 1992;Crigger et al 1996;Tal et al 1996) and human clinical studies (Al Arrayed et al 1995;Zitzmann et al 1997;Hockers et al 1999) presenting good clinical results for periodontal and bone regeneration.…”

The Role of Heparan Sulfate and Perlecan in Bone-regenerative Procedures

“…In an animal study measuring GTR outcomes, Pitaru et al (1991) concluded that the enrichment of barrier membranes with a combination of fibronectin and heparan sulfate promoted re-population of the surgically exposed root surfaces by connective tissue cells and prevented the apical migration of the epithelium during the first 20 days of healing, relative to sites receiving untreated membranes. A synthetic heparan sulfate mimetic has also been shown to induce healing in experimental craniotomy defects, by enhancing chemotaxis and differentiation of osteoprogenitor cells, and by increasing angiogenesis (Lafont et al, 2004).…”

“…For delivery, the surgical grafting materials and barrier membrane would either be pre-treated in a solution of perlecan, similar to the application of heparan sulfate and fibronectin to membranes by Pitaru et al (1991), or pre-treated with a vector delivery system, preferably in a sterile buffer such as phosphate buffer, pH 7.4. The pre-treatment may be performed during surgery, or at any time prior to the surgery, provided that the coated surgical implant material is not subject to denaturing temperatures at any time after pre-treatment, and would involve immersion in the perlecan solution for a short period of time.…”